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Actinic Keratosis – Pictures, Symptoms, Causes, Treatment

Updated on October 21, 2013

Actinic keratosis is a skin condition that occurs due to increased exposure to the sun. It causes the formation of tiny, rough and scaly spots.

Actinic keratosis is also referred to as ‘solar keratosis.’ The condition is usually asymptomatic. Initially, a tiny spot may appear on the skin which can later progress into actinic keratosis. It takes several years for the condition to fully develop. Actinic keratosis also poses great risk to development of skin cancer. It is possible to prevent the skin disorder by reducing the exposure of skin to excessive sunshine and taking relevant measures to guard it from the harmful ultraviolet rays.

Symptoms of actinic keratosis

Some of the signs and symptoms of actinic keratosis are listed below:

  • Formation of tiny rough areas on skin. Such abnormal spots are reddish in color and measure around 2 to 6 mm in diameter. Its scales may be yellowish or whitish, while the texture is coarse.

  • Sensations of burning and itchiness

  • Patients may experience pain and soreness when the spots rub against the clothes or are felt by fingers

  • The spots often change color from pink to red to brown or may become flesh colored.

  • The anomalous spots may appear to be somewhat elevated

  • The affected skin may occasionally feel like a thick lump

  • Actinic keratosis generally occurs on the hands, lips, neck, face and other parts of the body that are continuously in contact with the sun.

Causes of actinic keratosis

Actinic keratosis is primarily caused due to excessive exposure of the skin to the sun. Over a period of many years, the ultraviolet rays of the sun can cause extensive damage to the skin. If such damaged skin is further exposed to the harmful UV rays, then it increases the vulnerability to formation of skin cancer.

Actinic keratosis can occur in people of all age groups. However, the below mentioned risk factors can increase the susceptibility to the skin condition:

  • Presence of a weakened immune system

  • An increased age of over 40 years

  • A personal history of actinic keratosis

  • Residing in regions with hot weather conditions

  • Jobs that require long hours out in the sun, as well as prolonged outdoor excursions that result in development of freckles and sunburn

  • Individuals with light eyes, pale skin, blonde or red hair are at greater risk to developing actinic keratosis

Diagnosis of actinic keratosis

It is not always possible to gauge whether or not the abnormal lesions and spots are dangerous. However, if such anomalous spots begin to grow or elicit bleeding, then patients must seek immediate medical attention. Individuals may contact a dermatologist if the irregular spots display the below listed symptoms.

  • They itch or cause burning sensations

  • They are extremely painful

  • There is bleeding from the lesion

  • The patch becomes scaly

  • There is change in the color or size of the spots

The doctor will carry out a physical examination of the spots and determine the presence of actinic keratosis.

If the abnormal spots are thick or large, then a biopsy is usually recommended. It is a procedure wherein the abnormal tissue cells are investigated under a microscope. A biopsy helps the health care provider to ascertain whether the lesions are justactinic keratosis or whether they have progressed into skin cancer.

Treatment of actinic keratosis

Actinic keratosis may or may not progress into skin cancer. However, as the possibility of cancer remains, it is always a good option to treat and cure the skin disease. Complete cure may take a few days or even weeks. Patients need to avoid the sun during treatment.

The different treatment options for actinic keratosis are listed below:

  • Medications: Doctors may prescribe fluorouracil, a chemotherapy drug, to destroy the actinic keratosis skin cells. Topical medications like Aldara can also be applied on the affected spots. Such creams assist the body in rejection of cancer causing cells. The medications have certain side effects and hence need to be used as per the physician’s advice.

  • Dermabrasion: It is a procedure which involves the removal of spots affected by actinic keratosis via the rapid movement of a special brush. Healing takes a few months. There is minimal scarring.

  • Cryotherapy: This process involves the use of liquid nitrogen to freeze the abnormal spots. The skin then peels off and new skin grows in its place. There may be scarring, development of rough spots and skin darkening.

  • Curettage: The damaged skin cells are removed or scraped using a special medical tool called a curet. The remaining abnormal skin cells are then destroyed via electro-surgery.

  • Photodynamic therapy: Doctors will inject or apply a photosensitive agent on the affected spots so as to project and pin-point the abnormal actinic keratosis skin cells. Such cells are then destroyed via laser surgery.

  • Chemical peeling: Some specific chemicals are applied on the skin which causes the affected skin to peel off. The skin is then dressed up. New skin will develop on the spots during the healing process.


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